Congenital epulis : review of the literature and case report

The congenital epulis of the newborn is a rare benign tumor that occurs on the gingiva of the anterior alveolar ridge of the jaws. Originally described by Neumann in 1871, it is also known as a congenital gingival granular cell tumor. Congenital epulis is a pedunculated tumor of firm consistency with a smooth or lobulated surface. The size of the tumor varies from several millimeters to 9 cm in diameter. One hundred sixty-seven cases (195 lesions) have been reported since 1871. Females are affected 10 times more often than males. The gingival tumor originates from the maxillary alveolar ridge twice as often as from the mandible, usually in the incisor/canine region. Multiple tumors have been documented, as well as simultaneous involvement of the maxilla and mandible. Congenital epulis does not show growth after birth. Although spontaneous regression has occasionally been reported, it cannot be expected. Surgical excision is generally indicated and no recurrences have been noticed. On microscopic examination, a central mass of closely packed granular cells can be seen. The tumor is surrounded by a stratified squamous mucosa without pseudoepitheliomatous hyperplasia. A prominent arborizing fibrovascular network in the thin connective tissue septa is noted throughout the tumor. The histogenesis of the tumor is unknown.